CCFP-EM Salary

[areone]

Hi everyone!

I would like to know what the CCFP-EM salary would look like for someone working full time in the greater Montreal area. 

[emdog]

 In ontario expect 300-400k for full time work. CCFP-EM make same as other emerg docs. 

[MDinCanada]

2 hours ago, emdog said:

 In ontario expect 300-400k for full time work. CCFP-EM make same as other emerg docs. 

why do they make the same as other emerg docs? then what is the advantage of doing the R5?

[ArchEnemy]

14 minutes ago, MDinCanada said:

why do they make the same as other emerg docs? then what is the advantage of doing the R5?

Better training and preparedness. Better hiring prospects in large cities. 

[QuestionsAbound]

4 hours ago, MDinCanada said:

why do they make the same as other emerg docs? then what is the advantage of doing the R5?

You can do fellowships, like ICU or toxicology.

[JohnGrisham]

3 hours ago, ArchEnemy said:

Better training and preparedness. Better hiring prospects in large cities. 

And more opportunity to do research/other sub-specs.  At least from my 5yr EM colleagues, their perspective is that they get a lot of "extra" on-top, given the 5 year length.  

Not exactly needed for everyone either though.

[areone]

17 hours ago, emdog said:

 In ontario expect 300-400k for full time work. CCFP-EM make same as other emerg docs. 

And is there any overhead? 

[LittleDaisy]

9 hours ago, areone said:

And is there any overhead? 

Very low to little like below 5% as its essential inpatient service that requires 24/7 coverage; most hospital physicians don't pay very much overhead unless they are doing specifically outpatient work. Hence, why it is more difficult to get hospital jobs. 

[MDinCanada]

7 hours ago, LittleDaisy said:

Very low to little like below 5% as its essential inpatient service that requires 24/7 coverage; most hospital physicians don't pay very much overhead unless they are doing specifically outpatient work. Hence, why it is more difficult to get hospital jobs. 

Wouldn't it be beneficial to earn more but have a higher percentage of overhead? You could probably declare some of the overhead as business expenses no? For example, you could declare your property expenses as business expenses?

[LittleDaisy]

8 hours ago, MDinCanada said:

Wouldn't it be beneficial to earn more but have a higher percentage of overhead? You could probably declare some of the overhead as business expenses no? For example, you could declare your property expenses as business expenses?

I think so, but if you have 30% overhead for clinic for example.  You just write the tax expenses off: i.e: you don't pay taxes on them; but you only take home 70% of the salary.

Not to mention that incorporation and accountant fees would cost at least 3000-5000 a year. 

[ArchEnemy]

On 5/9/2020 at 1:21 PM, areone said:

And is there any overhead? 

This is a very important question that is often overlooked when discussing billings. 

300k-400k may seem "average" in terms of physician OHIP billing, but because their overhead is so low (<5%), their pre-tax income is similar to physicians who are billing 420-570k but have 30% overhead.

[MDinCanada]

19 hours ago, ArchEnemy said:

This is a very important question that is often overlooked when discussing billings. 

300k-400k may seem "average" in terms of physician OHIP billing, but because their overhead is so low (<5%), their pre-tax income is similar to physicians who are billing 420-570k but have 30% overhead.

Yeah this is too often ignored! Ophthalmologists have one of the highest billings but they also have some of the highest overhead. An ophthalmology clinic practically can't run without a very large team of assistants and expensive equipment.

Radiologists bill similar numbers as ophthos and don't have any overhead right?

[magneto]

On 5/8/2020 at 8:34 PM, MDinCanada said:

why do they make the same as other emerg docs? then what is the advantage of doing the R5?

Because both (FRs and CCFP-EMs) are emergency medicine physicians and they do the same thing.

 

 

[magneto]

On 5/8/2020 at 8:50 PM, ArchEnemy said:

Better training and preparedness. Better hiring prospects in large cities. 

This is partially incorrect.

The extra 2 year means longer training. It does not necessarily mean better training.

Yes, the 5 year program graduates have better hiring prospects.

This is because of two things. (1) When hiring committee is trying to differentiate between CCFP(EM) vs FRCPC(EM) graduate on paper, FRCPC(EM) has 2 additional years of training, and have used PGY4 year to do subspecialty training; (2) When CCFP(EM) and FRCPC(EM) graduate from same city applies to their home program, the hiring committee has known the FRCPC(EM) graduate for 5 years, whereas, they only know the CCFP(EM) resident for only 1 year - therefore, increasing the hiring prospects for FRCPC(EM) resident.

[magneto]

On 5/9/2020 at 12:35 AM, QuestionsAbound said:

You can do fellowships, like ICU or toxicology.

This is partially incorrect.

Many fellowships are now open to CCFP-EM residents including ultrasound fellowship, stimulation fellowship, flight medicine fellowship etc.

There are some fellowships that are not open currently for CCFP-EM residents including critical care fellowship, toxicology, 2 year pediatric emergency medicine fellowship (there is 1 year pediatric emergency medicine fellowship available for CCFP-EM residents in Toronto but it will not be possible to get hire into tertiary care pediatrics emergency medicine department).

[magneto]

On 5/9/2020 at 12:47 AM, JohnGrisham said:

And more opportunity to do research/other sub-specs.  At least from my 5yr EM colleagues, their perspective is that they get a lot of "extra" on-top, given the 5 year length.  

Not exactly needed for everyone either though.

In residency, because of the extra 2 years there is time to do more things like research and subspecialty training in PGY4.

However, once you start practicing, both CCFP(EM) and FRCPC(EM) graduates can do whatever. 

Many CCFP(EM) graduates have MSc, MD, MPH and thrive in research just like their FRCPC(EM) colleagues.

[ArchEnemy]

On 5/16/2020 at 6:24 PM, magneto said:

This is partially incorrect.

The extra 2 year means longer training. It does not necessarily mean better training.

Yes, the 5 year program graduates have better hiring prospects.

This is because of two things. (1) When hiring committee is trying to differentiate between CCFP(EM) vs FRCPC(EM) graduate on paper, FRCPC(EM) has 2 additional years of training, and have used PGY4 year to do subspecialty training; (2) When CCFP(EM) and FRCPC(EM) graduate from same city applies to their home program, the hiring committee has known the FRCPC(EM) graduate for 5 years, whereas, they only know the CCFP(EM) resident for only 1 year - therefore, increasing the hiring prospects for FRCPC(EM) resident.

I have to disagree: longer training will always lead to better training due to increased exposure and opportunities to apply skills in various scenarios. Sure a significant portion of that extra work may be repetitive, it is through repeated exposure and application that one is able to hone its craft.

I think it would also be very delusional to equate the first 2 years of FM training to the first 2 years of EM training. The extra 4 years of training is significant, and difference between a fresh CCFP(EM) and FRCPC(EM) graduate is stark (anecdotally). Once both have been in practice for a few years, then the difference is less noticeable. 

Otherwise, we should start equating NP to GP, GP-A to Anesthesia, GP-OB to OBGYN, GP-Sports Med to PMR right?

[magneto]

On 5/18/2020 at 12:59 PM, ArchEnemy said:

I have to disagree: longer training will always lead to better training due to increased exposure and opportunities to apply skills in various scenarios. Sure a significant portion of that extra work may be repetitive, it is through repeated exposure and application that one is able to hone its craft.

I think it would also be very delusional to equate the first 2 years of FM training to the first 2 years of EM training. The extra 4 years of training is significant, and difference between a fresh CCFP(EM) and FRCPC(EM) graduate is stark (anecdotally). Once both have been in practice for a few years, then the difference is less noticeable. 

Otherwise, we should start equating NP to GP, GP-A to Anesthesia, GP-OB to OBGYN, GP-Sports Med to PMR right?

I disagree. All everyone talks about is anecdotally. No one has proven actual data to prove the facts. If one training pathway was inferior, litigation lawyers/provincial licensing colleges/CMPA would have should down the inferior pathway already.

[ArchEnemy]

1 hour ago, magneto said:

I disagree. All everyone talks about is anecdotally. No one has proven actual data to prove the facts. If one training pathway was inferior, litigation lawyers/provincial licensing colleges/CMPA would have should down the inferior pathway already.

A study comparing the two would be very difficult and will be highly politicized. By way of your argument though, the quality of care provided by NP, GP-A and GP-OB must be equivalent (or non-inferior) to GP, Anesthetists and OBGYN respectively right? Since litigation lawyers / colleges / CMPA has not shut down any of these pathways either. 

[magneto]

1 hour ago, ArchEnemy said:

A study comparing the two would be very difficult and will be highly politicized. By way of your argument though, the quality of care provided by NP, GP-A and GP-OB must be equivalent (or non-inferior) to GP, Anesthetists and OBGYN respectively right? Since litigation lawyers / colleges / CMPA has not shut down any of these pathways either. 

There is difference in scope of practice between GP-A and anesthesiology, and between GP-OB and OBGYN. For example, GP-OB are not allowed to do C-sections.

There is NO difference in scope of practice between emergency physicians regardless of whether they were trained through FRCPC pathway or CCFP-EM pathway.

Hope that helps.

[1029384756md]

As an MD working in the industry now, I find it stupid how much BS physicians give each other over training pathways, sub-specialty fellowship requirements, and all the turf fights etc. No one knows or cares about any of that stuff outside of the hospital. The medical culture is amazing and mind boggling at times.

[magneto]

10 hours ago, 1029384756md said:

As an MD working in the industry now, I find it stupid how much BS physicians give each other over training pathways, sub-specialty fellowship requirements, and all the turf fights etc. No one knows or cares about any of that stuff outside of the hospital. The medical culture is amazing and mind boggling at times.

Agreed.

[MedZZZ]

How is the job prospect for FM + 1 EM in BC? Also, what steps one need to take to optimize the chances of matching to +! EM?

 

[familydoctatheart]

On 5/18/2020 at 12:59 PM, ArchEnemy said:

I have to disagree: longer training will always lead to better training due to increased exposure and opportunities to apply skills in various scenarios. Sure a significant portion of that extra work may be repetitive, it is through repeated exposure and application that one is able to hone its craft.

I think it would also be very delusional to equate the first 2 years of FM training to the first 2 years of EM training. The extra 4 years of training is significant, and difference between a fresh CCFP(EM) and FRCPC(EM) graduate is stark (anecdotally). Once both have been in practice for a few years, then the difference is less noticeable. 

Otherwise, we should start equating NP to GP, GP-A to Anesthesia, GP-OB to OBGYN, GP-Sports Med to PMR right?

Agreed that can't compare first two years of EM as Fam med. However, 90%+ presentations a family doctor can easily take care of. The other 10% is what the EM trains you for. I have done 4 years of clinic medicine, inpatient medicine and ER medicine then challenged the exam. I now work at in a bigger center now. Working at a tertiary centre I find much easier and mundane than working in a rural setting where you truly do get to implement clinical skills due to lack of resource/specialist back up. I still do shifts in rural EDs and my heart rate always climbs up way higher intubating or resuscitating a patient that at a tertiary center with a gazillion backups. Also my years spent in family medicine --- I often will send patients home with statins, diabetic medications, inject people's joints in ED and prescribe anti-depressants from ED whereas the FRCPC(EM) don't do. So what do I bring to the table that the FRCP doesn't have: clinic perspective + medicine background + ER medicine and years of experience. Just having more training doesn't mean anything unless you are training to do surgeries or procedures. Practice is where its at. Also note that I am much faster than FRCP(EM) docs and I order less tests because I have seen a gazillion normal presentations of normal things in clinic. 

[JohnGrisham]

This disusssion will get quite circular, and anecdotally I would say not all EM docs are alike, regardless of +1 vs 5 year. But also there is regional variation. In some centres, +1s will not be working in bigger high level of care EDs, whereas in others they will be. You can't compare ED practice in a glorified walk-in-clinic for example to a fully functioning trauma centre with a large catchment area of pathology. But as Magneto pointed out, there isn't much objective evidence to say one way or the other. But overall, I think most will agree - we need both +1 and 5 years, and certainly there are significant benefits to having a +1 with a full-scope FM background, as EDs are overfilled with people who really just need a good capable FM doc, and not a million tests to cover your ass.